Breast augmentation is the surgical placement of either a saline or a silicone breast implants in an effort to increase breast fullness or to correct breast asymmetry. The implants may be placed above or below the pectoralis major muscle depending on clinical circumstances or patient preference. In addition, there are various surgical incisions which may be used to place the implants. Clinically referred to as augmentation mammaplasty, the procedure is used cosmetically to:
•Enlarge a naturally small breast, most commonly the result of heredity (micromastia)
•Restore breast volume lost following pregnancy, as a result of breast-feeding or due to weight loss
•Achieve better symmetry when breasts are moderately disproportionate in size and shape
The procedure takes approximately 90 minutes and is done under general anesthesia as an outpatient. Generally the patient does NOT have drains placed with this procedure. Patients are asked not to lift greater than 10 lbs for the first 3 weeks. They may resume unrestricted physical activity at approximately 6 weeks post procedure. Patients experience minimal pain the first 72-96 hours which is controlled by oral pain medication and oral antispasmodic medications. Most patients are able to return to work within 5-7 days if they are able to avoid lifting or straining at work.
Mastopexy (Breast Lift)
Breast mastopexy is procedure which focuses on repositioning of the nipple and areola complex to a more natural and desirable position. In patients who have a significant amount of breast tissue, a mastopexy can be performed without placement of an implant. However, more often, the patient desires an increase in the upper pole as well as increased breast cleavage. A breast implant helps achieve both of these objectives. The implant may be placed at the same time as the mastopexy or they may be placed in a delayed manner approximately 3 months after the initial mastopexy (Lift).
Reduction Mammoplasty (Breast Reduction)
Women who have larger breasts associated with neck and back pain, shoulder strap grooving and moisture, rashing and irritation under the breasts are referred to as having symptomatic macromastia. If the patient is unable to alleviate such symptoms with anti-inflammatory medication or weight loss then surgery becomes a reasonable option. The surgery takes approximately three hours and is done as an outpatient. There are 2 drains placed which are in place for 3-5 days post operatively. Patients are encouraged to avoid heavy lifting or straining for the first 3 weeks after surgery. By 6 weeks post operatively, most patients can resume a normal unrestricted level of activity. It is not uncommon to experience some degree of wound separation or drainage along the inframmary fold incision. These issues are generally minimal and self-limiting. The use of daily dressing changes are the only type of treatment generally needed.
This procedure is one which most patients feel better almost immediately after surgery. They state that it is easier to breath and that their neck pain is significantly better without the weight of their breast pulling on their upper back and neck. In fact, most wish they had the procedure years earlier.
When having breast surgery it is important to remember that it takes approximately three months for swelling to settle and for the breast to assume their final position. As a result, the shape and contour will undergo many changes from the initial surgery until the final appearance. It is difficult to assess the need for any type of revisional surgery prior to the 3 month post-operative point.